435202744-11-20-2025-26-AS-RMAO-DPMUS7-20251223144953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 11/20/2025
Date Signed: 11/20/2025 02:53:49 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2024 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20240613120601

FACILITY NAME:	WESTMONT OF MILPITAS		FACILITY NUMBER:	435202744
ADMINISTRATOR:	BECKER, GREGORY		FACILITY TYPE:	740
ADDRESS:	80 CEDAR WAY		TELEPHONE:	(408) 770-9575
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	225	CENSUS: 183	DATE:	11/20/2025
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Administrator Meghian Geul		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Staff did not ensure that a resident's medication was inaccessible to another resident
Staff did not ensure that a resident consumed medication as prescribed
Staff did not prevent resident from wandering into another resident's room
Staff did not notify responsible party regarding increase of facility fees

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Meghian Geul.

On June 13, 2024 the Department received a complaint alleging Staff did not ensure that a resident's medication was inaccessible to another resident / Staff did not ensure that a resident consumed medication as prescribed.

On June 13, 2024, the Department interviewed Witness W1. W1 stated that two years ago (W1 stated he/she doesn't know the date), R1 took resident R2’s medication from his/her plate then consumed the medications.

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Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 26-AS-20240613120601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: WESTMONT OF MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 11/20/2025

NARRATIVE

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On June 20, 2024, LPA Simi Rai interviewed staff S1. S1 stated he/she does not recall if a resident consumed medications that were left on the table. S1 stated in Memory Care unit the protocol is to ensure the resident takes the medication and wait with them until they swallow the medication. S1 stated the med-tech doesn’t leave the medication lying around because the resident may forget to take the medication.

On September 30, 2025, LPA Manuel Monter interviewed residents R3-R7. 5 Out of 5 residents (R3-R7) stated they handle their own medications, doesn’t need staff assistance and hasn’t had any issues with his/her medications.

LPA Monter interviewed Staff S1-S3, S5. LPA also interviewed S4 & Current Memory Care Director, Norlynn Peterson. Staff S1-S3 & S5 stated staff gives residents their medications in person. Staff S1-S3,S5 stated medications are not given when residents are dinning. 5 Out of 5 staff (S1-S5) stated they haven’t seen or heard about residents taking each others medications.

On October 6, 2025, LPA Manuel Monter interviewed Witness W1. W1 stated he/she doesn’t remember when the incident where R1 took R2’s medication occurred. W1 stated he/she was contacted by an unknown staff who informed him/her about this incident.

On November 20, 2025, LPA Monter interviewed residents R2, R8-R11. 2 Out of 5 residents(R8, R9) interviewed stated they have not had any issues with receiving their medication. 2 Out of 5 residents(R8, R9) interviewed stated there hasn't been a time when they observed a resident taking other residents medication. 3 Out of 5 residents (R2, R10, R11) interviewed were unable to provide any relevant information due to neruocgonetive disorder.

LPA interviewed staff S6-S9. 4 Out of 4 staff (S6-S9) stated medications are administered to residents in person, and the medtech will watch them take the medication before leaving. 4 Out of 4 staff (S6-S9) stated they haven't seen or heard about any instance of a resident taking another residents medication and consuming it.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 26-AS-20240613120601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: WESTMONT OF MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 11/20/2025

NARRATIVE

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On November 20, 2025, LPA Manuel Monter randomly audited 5 resident’s medications. LPA audited the medications by cross referencing the medication bottles/ containers and cross referencing with the Centrally Stored Medication Record and Medication Administration Record. No discrepancies were noted during review.

The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

Staff did not prevent resident from wandering into another resident's room

On June 13, 2024 the Department received a complaint alleging Staff did not prevent resident from wandering into another resident's room.

On June 13, 2024, the Department interviewed Witness W1. W1 stated that in January 2023 (W1 doesn't know the date of this event) during dinner time, staff went looking for R1 and found the R1 lying on the floor in another resident's room. W1 stated he/she doesn't know how long R1 was inside of the other resident's room.

On June 20, 2024, LPA Simi Rai interviewed Staff S1. S1 stated he/she does not recall when R1 was found lying on the floor of another resident's room.

On September 30, 2025, LPA Manuel Monter interviewed residents R3-R7. 5 Out of 5 residents (R3-R7) stated they have not had any issues with other residents wandering into his/her apartment.

LPA Monter interviewed Staff S1-S3, S5. LPA also interviewed S4 & Current Memory Care Director, Norlynn Peterson. 5 Out of 5 staff (S1-S5) interviewed stated if there residents who attempts to enter another resident’s bedroom, then staff will redirect them.

On October 6, 2025, LPA Manuel Monter interviewed Witness W1. W1 stated regarding R1’s wandering, that he/she was informed by an unknown staff. W1 stated he/she doesn’t remember what room R1 entered or how long R1 was there. Page 3 Out of 5.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 26-AS-20240613120601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: WESTMONT OF MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 11/20/2025

NARRATIVE

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On November 20, 2025, LPA Monter interviewed residents R2, R8-R11. 2 Out of 5 residents(R8, R9) interviewed stated they have not had any issues with other residents wandering or going into their bedroom and have not witnessed that occurring. 3 Out of 5 residents (R2, R10, R11) interviewed were unable to provide any relevant information due to neruocgonetive disorder.

LPA interviewed staff S6-S9. 4 Out of 4 staff (S6-S9) stated there are residents who have the behavior of wandering and attempting to enter another residents bedroom. 4 Out of 4 staff (S6-S9) stated when this behavior is observed, staff will re-direct the resident.

The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

Staff did not notify responsible party regarding increase of facility fees

On June 13, 2024 the Department received a complaint alleging Staff did not notify responsible party regarding increase of facility fees.

On June 13, 2024, the Department interviewed Witness W1. W1 stated in January 2024 (W1 stated he/she doesn't know the date) the facility increased R1’s facility fees from $7,500.00 to $9,000.00. W1 stated that prior to billing him/her, staff did not provide him/her with written notice.

On September 30, 2025, LPA Manuel Monter interviewed Staff S4 & Current Memory Care Director, Norlynn Peterson. S4 stated when the facility notices residents now have a higher level of care, they will notify the staff. S4 stated they will then inform the staff of the updated care needs of said resident. S4 stated they will update the family regarding changes in care and the changes of cost as well. S4 stated ultimately the family has to agree. S4 stated if a residents level of care does go up, they naturally the residents cost of care would increase.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 26-AS-20240613120601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: WESTMONT OF MILPITAS	FACILITY NUMBER: 435202744
	VISIT DATE: 11/20/2025

NARRATIVE

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On October 6, 2025, LPA Monter interviewed Witness W1. W1 stated regarding the change in the fees, that he/she was informed by the staff that R1 had a higher level of care. W1 stated he/she was told the change of fees was for the level of care from level 1 to level 3. W1 did acknowledge that R1 was declining. W1 stated R1 began to show wandering behaviors when he/she moved into the facility.

The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

Page 5 Out of 5. END OF REPORT.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

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